Barriers and Enablers of Second-Order Problem-Solving Behavior: How Nurses Can Break Away From the Workaround Culture.

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From: Quality Management in Health Care(Vol. 31, Issue 3)
Publisher: Lippincott Williams & Wilkins, WK Health
Document Type: Brief article
Length: 315 words

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Byline: Sem Vanbelleghem, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium (Mr Vanbelleghem); Departments of Marketing, Innovation and Organization (Drs De Regge and Gemmel) and Public Health and Primary Care (Dr Gemmel), Ghent University, Ghent, Belgium; Departments of Strategic Policy Cell (Dr De Regge) and Gastrointestinal Surgery (Dr Van Nieuwenhove), Ghent University Hospital, Ghent, Belgium; and Faculty of Medicine and Health Sciences, Department of Human Structure and Repair, Ghent University Hospital, Ghent, Belgium (Dr Van Nieuwenhove).; Melissa De Regge; Yves Van Nieuwenhove; Paul Gemmel Abstract BACKGROUND AND OBJECTIVES: Nurses are challenged by numerous day-to-day unexpected problems due to poorly performing work systems that hinder patient care. These operational failures persist in hospitals, partly because nurses tend to prefer quick fixes or workarounds over real improvements that prevent recurrence. The aim of this review is to shed light on the barriers to and enablers of nurses' second-order problem-solving behavior and their consequences, so that hospitals can learn from failure and improve organizational outcomes. METHODS: We conducted a systematic review, with quantitative, qualitative, and mixed-method articles, searching 6 databases (PubMed, Embase, Web of Science, CINAHL, and Google Scholar) following the Preferred Items for Systematic Review and Meta-Analysis (PRISMA) guidelines. Quality assessment for inclusion was performed by 2 independent authors using the Mixed Methods Appraisal Tool (MMAT). A descriptive synthesis was used for analysis. RESULTS: This study reveals the barriers and enablers for second-order problem-solving behavior, and synthesizes improvement proposals within 3 perspectives, namely the "empowerment" perspective, the "process improvement" perspective, and the "time" perspective. Furthermore, we found that limited attention is given to the patient's perspective, and the existence of a no-action behavior. CONCLUSION: Although operational failures have several important consequences for hospital staff and organizations, there has been hardly any research into the barriers and enablers that initiate second-order problem-solving behavior; stemming this nursing behavior has thus rarely appeared as a suggestion for improvement.

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Gale Document Number: GALE|A707820653